News Release

Date Posted

SACRAMENTO, Calif. — Covered California Board Chair Diana Dooley on Tuesday thanked two departing members of the Board of Directors and welcomed two new members appointed by Gov. Jerry Brown to oversee the agency.

Dr. Sandra Hernandez and Jerry Fleming will serve on the board, taking the places of Marty Morgenstern and Genoveva Islas, who have served since 2015.

Dooley said Morgenstern and Islas will be missed.

“We want to thank both Marty and Veva for the time and effort they have devoted to helping Covered California build an organization that has helped millions of people get affordable health care,” said Dooley. “They both have served the people of California with dedication and a steadfast commitment to putting the needs of consumers first.”

Hernandez and Fleming will join Dooley, Paul Fearer and Art Torres as members of Covered California’s Board of Directors.

Peter V. Lee, executive director of Covered California, said the organization is grateful for the leadership of the departing board members.

“Marty and Veva joined us right after our second open-enrollment period, and their expertise and commitment helped Covered California maintain its momentum and strength,” Lee said. “We want to thank them for everything they have done.”

“We also look forward to welcoming Jerry Fleming and Sandra Hernandez, who bring not only broad and deep expertise in health care, but also tremendous insight into how to ensure Covered California continues to reach and effectively serve the rich diversity of California’s population,” Lee said.

Since 2014, more than 3.4 million people have purchased health insurance through Covered California, and nearly 4 million have enrolled in the state’s Medi-Cal program. Together, the gains have cut the rate of the uninsured in California from 17 percent in 2013 to a historic low of 6.8 percent as of June 2017.

Eligible consumers who are interested in signing up should go to www.CoveredCA.com where they can get help to enroll. They can explore their options and find out if they qualify for financial help by using the Shop and Compare Tool. They can also get free and confidential enrollment assistance by visiting www.coveredca.com/find-help/ and searching among 800 storefronts statewide, or more than 17,000 certified enrollers who can assist consumers in understanding their choices and enrolling, including individuals who can assist in other languages. In addition, consumers can reach the Covered California service center by calling (800) 300-1506.

Consumers who qualify for Medi-Cal can enroll year-round.

About Covered California
Covered California is the state’s health insurance marketplace, where Californians can find affordable, high-quality insurance from top insurance companies. Covered California is the only place where individuals who qualify can get financial assistance on a sliding scale to reduce premium costs. Consumers can then compare health insurance plans and choose the plan that works best for their health needs and budget. Depending on their income, some consumers may qualify for the low-cost or no-cost Medi-Cal program.

Covered California is an independent part of the state government whose job is to make the health insurance marketplace work for California’s consumers. It is overseen by a five-member board appointed by the governor and the Legislature. For more information about Covered California, please visit www.CoveredCA.com.

More than 50,000 people selected health insurance plans through Covered California in the final three days of open enrollment.

Covered California has now served more than 3.4 million consumers since 2014.

The number of renewing enrollees dropped slightly, in part due to Covered California encouraging unsubsidized Silver plan enrollees to shop off-exchange.

Consumers made smart choices for 2018, picking Gold plans in many cases to get the best value for themselves and their families.

Subsidized consumers paid less for health coverage in 2018 than 2017 due to the protective effect of their subsidy rising to offset higher premiums, while unsubsidized consumers in the individual market — both in and out of Covered California — saw their costs rise.

Without action by Congress, unsubsidized consumers nationwide could see their costs rise steeply in 2019 and find coverage increasingly unaffordable.

SACRAMENTO, Calif. — Covered California announced Wednesday that more than 50,000 new consumers selected a plan during the final three days of open enrollment, bringing its overall total to 423,484 plan selections, which represents a 3 percent increase over last year.

“With robust marketing and strong partnerships in communities across California, we attracted more people to Covered California to newly enroll in health insurance this year,” said Peter V. Lee, executive director of Covered California. “Another key factor was that those getting subsidies actually had more money to shop with due to the work-around we implemented to make sure the cost-sharing reduction benefit was funded. With this increased support, we saw new and renewing consumers make smart choices, with many more opting for Gold-tier plans this year compared to last.”

Among those who receive financial assistance, 15 percent of new consumers selected a Gold plan during open enrollment, over three times as many as the 4 percent that selected a Gold plan last year (see Table 1: Covered California Open Enrollment Subsidized Plan Selections by Metal Tier). Covered California’s Gold plans generally have higher premiums but pay 80 percent of consumers’ health care costs when they access care. Gold plans were a better value for consumers this year because the premium was lower due to the cost-sharing reduction surcharge that was added only to Silver plans.

Lee said the data shows consumers are making wise choices about health insurance.
“If price were the only thing that mattered, consumers would have largely moved to Bronze-level plans, which have the lowest price,” Lee said. “But instead we saw a ‘gold rush’ of smart shopping in 2018, with consumers buying a richer benefit with their increased subsidy dollars.”

The number of new consumers selecting Platinum plans increased from 2 percent to 4 percent, while the number of consumers selecting a Bronze plan increased from 29 percent to 31 percent. Consequently, the number of new consumers selecting a Silver plan dropped from 63 percent last year to 49 percent this year.

The cost-sharing reduction “work-around” was designed to protect the hundreds of thousands of Californians who do not receive federal subsidies. One of the impacts of the cost-sharing reduction work-around was that Covered California encouraged unsubsidized enrollees who had bought Silver plans in 2017 to consider getting the comparable product off-exchange for 2018 and avoid paying the cost-sharing reduction surcharge. “While we’re still analyzing the data, it’s clear that some of the decrease in our renewals was due to consumers moving off-exchange to get coverage,” said Lee. “This fact underscores that our reports only tell part of the story of the individual market in California.”

Lee also offered observations Wednesday about enrollment in the federal insurance marketplace and other state-based exchanges.

“We are seeing remarkable stability in exchanges across the nation. While the federally facilitated marketplace has seen a decline of over 10 percent since 2016, states like California that are served by state-based marketplaces have on average grown by 1.5 percent in the same period,” Lee said. “Dropping enrollment in states that rely on the federal government for marketing and outreach will directly translate to higher premiums due to the worse risk mix. With the potential dramatic rate increases likely in many states, those states that don’t have state-based marketing efforts are at risk of seeing spiraling costs for the unsubsidized, which will likely price millions out of the ability to afford insurance.”

Lee’s comments coincide with new data compiled by the National Academy for State Health Policy (NASHP) that shows that state-based marketplaces’ enrollment outpaced that of the federally facilitated marketplace.

“We know that enrollment in the federal health exchange has been hampered by dramatic cuts in marketing and funding for Navigators to help people enroll,” Lee said. “Our preliminary analysis suggests there has been a dramatic drop in new enrollments in the last two years, meaning the federal exchange is not ‘refilling the bucket’ with new enrollees even though their renewals are holding steady.”

Over the past four years, the number of consumers newly enrolling in federally facilitated marketplace states has dropped from 4.7 million in 2015 to 2.5 million in 2018. In particular, in the two years that the current administration has been at least partially responsible for promoting enrollment — which included the decision to reduce marketing during the end of open enrollment for the 2017 plan year and to reduce marketing spending dramatically for 2018 — new enrollment has declined 38 percent (from 4 million in 2016 to 2.5 million in 2018). (See Fig. 1: National Enrollment Trends, New and Total Enrollment .)

“The problem,” Lee noted, “is that new enrollees refresh the risk mix and help keep rates down. Failing to ‘refill the bucket’ at the top — coupled with the rate increases due to ending the individual mandate — means that enrollment in the federal marketplace, and the individual market more broadly, is headed for trouble next year unless action is taken soon.”

Covered California also released analysis of the premium changes for both subsidized and unsubsidized consumers over the past four years (see Fig. 2: California’s Individual Market Premiums for Subsidized and Unsubsidized Consumers, on next page).

That data confirmed how the financial subsidies are bringing health care within reach to the 85 percent of Covered California enrollees who receive subsidies — with their cost of coverage dropping 11 percent in 2018, reflecting an average monthly cost of $116.
At the same time, the data finds that for unsubsidized consumers — buying either through Covered California or directly from the same carriers in the individual market —premiums increased at an average annual rate of 7.2 percent.

“An average monthly premium of $503 can be tough for those not getting subsidies,” said Lee. “However, over the past four years we’ve kept premium increases to about 7 percent. Our efforts to enroll a healthy pool of enrollees are paying off in lower increases for those who pay the full premium.”

“Those who do not get help to buy health insurance — an estimated 6 million people across the country — will not have any protection against those rate increases,” Lee said. “The unsubsidized are too often forgotten, and we know that most are middle class Americans with a median income of $75,000. Many will be priced out of coverage if premium hikes are not held in check.”

Earlier this year Covered California released a study that found the enrollment drop in 2018 nationally could have been even greater if not for a dramatic increase in the news coverage of the enrollment periods and deadlines. Ogilvy, a global leader in communications and media, was commissioned to examine coverage trends for the 2017 and 2018 open-enrollment periods across the country. The report found that mentions of “enrollment,” “enrollment period” and “deadline” increased by 53 percent, 125 percent and 129 percent respectively year over year (see Fig. 3: National News Coverage About Open Enrollment Increased Dramatically Year Over Year).

In the absence of federal or state policy changes, rate increases in California in 2019 are likely to be steep but on the “low end” of the range for states nationally due to the starting relatively healthy risk mix and Covered California’s commitment to maintaining a robust marketing campaign to attract and retain a healthy consumer pool that reduces premiums for everyone.

Lee said federal action to stabilize the individual market could make a big difference for millions of unsubsidized consumers who otherwise will face large rate increases.

Since 2014, more than 3.4 million people have purchased health insurance through Covered California, and nearly 4 million have enrolled in the state’s Medi-Cal program. Together, the gains have cut the rate of the uninsured in California from 17 percent in 2013 to a historic low of 6.8 percent as of June 2017.

Eligible consumers who are interested in signing up should go to www.CoveredCA.com where they can get help to enroll. They can explore their options and find out if they qualify for financial help by using the Shop and Compare Tool. They can also get free and confidential enrollment assistance by visiting www.coveredca.com/find-help/ and searching among 800 storefronts statewide, or more than 17,000 certified enrollers who can assist consumers in understanding their choices and enrolling, including individuals who can assist in other languages. In addition, consumers can reach the Covered California service center by calling (800) 300-1506.

Consumers who qualify for Medi-Cal can enroll year-round.

[1] The NASHP report includes data as reported to the federal government, including more than 388,000 new enrollees who signed up for Covered California during the fifth open-enrollment period and 1.13 million re-enrolling consumers. Covered California reports 423,484 enrollees in order to be consistent with reporting new plan selections in each of the last five years. Not all consumers who sign up during open enrollment end up with effectuated coverage. Complete totals for effectuated enrollment are released in Covered California’s Active Member Profiles athttp://hbex.coveredca.com/data-research/.

Data for 2018 from Centers for Medicare and Medicaid Services, “Final Weekly Enrollment Snapshot For 2018 Open Enrollment Period” (December 28, 2017):https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2017-Fact-Sheet-items/2017-12-28.html?DLPage=1&DLEntries=10&DLSort=0&DLSortDir=descendingand equivalent state marketplace data compiled by the National Academy for State Health Policy.[3] Unsubsidized consumers are those who do not receive financial assistance from the federal government to pay their health insurance premiums. These consumers can purchase inside and outside of the exchange. Unsubsidized consumers in the individual market total 1.15 million, of whom roughly 1 million are in Affordable Care Act-compliant, non-grandfathered plans. See below for more detail about the unsubsidized premiums shown.Subsidized consumers are those who receive substantial financial assistance from the federal government to pay their health insurance premiums. The Affordable Care Act requires consumers to purchase through the exchange to receive this assistance. In California, subsidized consumers total approximately 1.2 million people.

Premiums are the actual observed average premiums in Covered California administrative data for renewal and open enrollment plan selections, and the percentage change is the change to the average observed premiums. Year over year, the average premiums shown may be influenced by changes in the population distributions (such as for region, age, metal tier, etc.). Average premiums for the off-exchange market as a whole could differ from the Covered California unsubsidized premiums to the extent that the off-exchange population and plan-choice profiles differ from the on-exchange, unsubsidized profile. Additionally, the 2018 unsubsidized premiums have been adjusted to remove the cost-sharing reduction “surcharge” in Silver, since off-exchange enrollees do not incur the surcharge and Covered California encouraged its unsubsidized Silver enrollees to move off-exchange to avoid the surcharge in 2018.

About Covered California
Covered California is the state’s health insurance marketplace, where Californians can find affordable, high-quality insurance from top insurance companies. Covered California is the only place where individuals who qualify can get financial assistance on a sliding scale to reduce premium costs. Consumers can then compare health insurance plans and choose the plan that works best for their health needs and budget. Depending on their income, some consumers may qualify for the low-cost or no-cost Medi-Cal program.

Covered California is an independent part of the state government whose job is to make the health insurance marketplace work for California’s consumers. It is overseen by a five-member board appointed by the governor and the Legislature. For more information about Covered California, please visit www.CoveredCA.com.

Due to an expected increase in demand today, consumers who start an application before midnight will be able to work with a certified enroller to complete the process on Thursday or Friday.

Covered California Service Center representatives are available to help through midnight on the 31st and through 8 p.m. on Feb. 1 and 2.

SACRAMENTO, Calif. — On the final day of open enrollment, with tens of thousands of people expected to sign up for health coverage, Covered California announced it would help consumers “cross the finish line” if they get caught up in the surge of last-minute shoppers.

“Our numbers are very strong this year, and history shows us that thousands of consumers will sign up on the last day,” said Peter V. Lee, executive director of Covered California. “Health care is too important, and we want to make sure that people who want to get covered are not caught up in today’s expected surge of last-minute shoppers.”

Consumers who begin their application by the end of Jan. 31 will have until midnight Feb. 2 to complete the process with the help of a Certified Insurance Agent. They may also get help from a Service Center representative, but only through 8 p.m. on Thursday and Friday. Community enrollment partners such as Certified Enrollment Counselors, Certified Application Counselors and Plan-Based Enrollers will also be able to assist.

Those who finish their application by Feb. 2 will have their health care coverage start on March 1, 2018.

“Our top priority is making sure Californians have the time and help they need to find the Covered California health plan that works best for them,” Lee said. “Covered California has partners who will make enrollment easier than you think, and with the financial help that is available it can be more affordable than you realize.”

A recent Covered California analysis found that the net monthly premiums for enrollees who receive financial help are on average 10 percent lower than what new and renewing consumers paid last year. The lower prices are a result of more financial help being available for consumers who qualify for assistance. The Affordable Care Act is designed to protect consumers by providing more premium tax credits when premiums rise. And for the many Californians in the individual market who do not get financial help, the robust competition has meant that for many, premium increases have been kept in the single digits.

Since 2014, more than 3 million people have purchased health insurance through Covered California, and nearly 4 million have enrolled in the state’s Medi-Cal program. Together, the gains have cut the rate of the uninsured in California from 17 percent in 2013 to a historic low of 6.8 percent as of June 2017.

Consumers interested in learning more about their coverage options should go to www.CoveredCA.com where they can get help to enroll. They can explore their options and find out if they qualify for financial help by using the Shop and Compare Tool. They can also get free and confidential enrollment assistance by visiting www.coveredca.com/find-help/ and searching among 800 storefronts statewide, or more than 17,000 certified enrollers who can assist consumers in understanding their choices and enrolling, including individuals who can assist in other languages. In addition, consumers can reach the Covered California service center by calling (800) 300-1506.

Once open enrollment ends, consumers may sign up only if they experience a life-changing event such as losing their health care coverage, getting married, having a child or moving. Medi-Cal enrollment is year-round.

About Covered California
Covered California is the state’s health insurance marketplace, where Californians can find affordable, high-quality insurance from top insurance companies. Covered California is the only place where individuals who qualify can get financial assistance on a sliding scale to reduce premium costs. Consumers can then compare health insurance plans and choose the plan that works best for their health needs and budget. Depending on their income, some consumers may qualify for the low-cost or no-cost Medi-Cal program.

Covered California is an independent part of the state government whose job is to make the health insurance marketplace work for California’s consumers. It is overseen by a five-member board appointed by the governor and the Legislature. For more information about Covered California, please visit www.CoveredCA.com.

Covered California’s “Covered in Art” tour visits Charles R. Drew University of Medicine and Science to unveil new mural and promote enrollment.

Californians who need health insurance are encouraged to sign up before midnight on Wednesday, Jan. 31, to get coverage for 2018.

Consumers can visit www.CoveredCA.com to explore their options and see if they qualify for financial assistance to help buy health insurance.

LOS ANGELES, Calif. — Covered California hit the road again on Monday, bringing its statewide bus tour to the renowned Charles R. Drew University of Medicine and Science to promote health insurance enrollment and alert uninsured consumers that they have until Jan. 31 to sign up for coverage under the Patient Protection and Affordable Care Act.

“The demand for health insurance and real, affordable health care is stronger than ever, and we’re here to help those who have not yet signed up to get over the finish line,” said Covered California Executive Director Peter V. Lee. “Open enrollment ends Wednesday, Jan. 31, and we don’t want to leave anyone behind.”

Covered California announced that 342,000 new consumers had signed up for health insurance through Covered California through Sunday, Jan. 21. The pace of new enrollees for the current open-enrollment period remains ahead of last year, when sign-ups did not surpass 320,000 until Jan. 23, 2017.

In addition to the new sign-ups, more than 1.2 million existing Covered California members have renewed their coverage for 2018. And the good news is that the vast majority will see a decrease in their net monthly premium payment after receiving more financial assistance.

The stop at Charles R. Drew University (CDU) is part of Covered California’s “Covered in Art” bus tour, a campaign that has taken the agency to communities throughout the state where local artists are painting murals to attract attention to enrollment centers and promote health and wellness. In all, 17 murals will be painted.

“We are gratified and humbled to be part of the ‘Covered in Art’ bus tour with Covered California,” said Dr. David M. Carlisle, president and CEO of Charles R. Drew University of Medicine and Science. “As a health-professions university founded to address health inequities in under-resourced communities, CDU shares the values of Covered California and the conviction that health care is an absolute right for all.”

Charles R. Drew University is a private, nonprofit, community-founded, student-centered university committed to cultivating diverse health-professional leaders who are dedicated to social justice and health equity for underserved populations through outstanding education, clinical service and community engagement. CDU is also a leader in health-disparities research with a focus on education, training, treatment and care in cancer, diabetes, cardio-metabolic disorders and HIV/AIDS.

In the five decades since the school was incorporated in the Watts-Willowbrook area of Los Angeles, CDU has graduated more than 575 physicians, 1,200 physician assistants and over 1,000 other health professionals, as well as trained over 2,700 physician specialists through its sponsored residency programs. Its School of Nursing has graduated over 1,000 nursing professionals, including more than 600 family nurse practitioners.

“The ‘Covered in Art’ project is a living demonstration of the fact that health care is local and that Covered California is woven into the fabric of local communities,” Lee said.

The 69-by-30-foot mural at CDU will feature an image of civil rights icon Martin Luther King Jr. with one of King’s most famous quotes about health disparities: “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.”

Created by artist Shawn Michael Warren, the mural is designed to inspire reflection on the advancement of civil rights and Covered California’s role in achieving equal access to health care.

Warren’s artistic and visual inspirations are rooted in the traditions and philosophies of centuries-old artists. His work is influenced by artists such as Bouguereau, Sargent, Thayer, Vernet and Zorn, and through his studies of classical art at the Florence Academy of Art.

Lee said Covered California is wrapping up its fifth open-enrollment period with high interest from consumers and robust support for those who wish to enroll.

“Consumers can find resources on our website and even enroll on their cell phones. In addition, we have new tools that make it easier to shop and easier to find resources in other languages.”

A recent Covered California analysis found that the net monthly premiums for enrollees who receive financial help are on average 10 percent lower than what new and renewing consumers paid last year. The lower prices are a result of more financial help being available for consumers who qualify for assistance. The Affordable Care Act is designed to protect consumers by providing more premium tax credits when premiums rise.

Since 2014, more than 3 million people have purchased health insurance through Covered California, and nearly 4 million have enrolled in the state’s Medi-Cal program. Together, the gains have cut the rate of the uninsured in California from 17 percent in 2013 to a historic low of 6.8 percent as of June 2017.

“We want consumers to know we’re offering the same quality coverage we’ve offered since we opened our doors in 2014,” Lee said. Covered California is here for you today and will be here for you tomorrow.”

Consumers interested in learning more about their coverage options should go to www.CoveredCA.com where they can get help to enroll. They can explore their options and find out if they qualify for financial help by using the Shop and Compare Tool. They can also get free and confidential enrollment assistance by visiting www.coveredca.com/find-help/ and searching among 800 storefronts statewide, or more than 17,000 certified enrollers who can assist consumers in understanding their choices and enrolling, including individuals who can assist in other languages.

In addition, consumers can reach the Covered California service center by calling (800) 300-1506.About Covered California
Covered California is the state’s health insurance marketplace, where Californians can find affordable, high-quality insurance from top insurance companies. Covered California is the only place where individuals who qualify can get financial assistance on a sliding scale to reduce premium costs. Consumers can then compare health insurance plans and choose the plan that works best for their health needs and budget. Depending on their income, some consumers may qualify for the low-cost or no-cost Medi-Cal program.

Covered California is an independent part of the state government whose job is to make the health insurance marketplace work for California’s consumers. It is overseen by a five-member board appointed by the governor and the Legislature. For more information about Covered California, please visit www.CoveredCA.com.

The Patient Protection and Affordable Care Act’s requirement that consumers have health insurance remains in place, and consumers may face stiff tax penalties if they are not covered in 2018.

A recent study estimates 70 percent of consumers, who are uninsured and eligible for financial help, could purchase health insurance coverage for less than the price of the tax penalty.

Most consumers are paying less in monthly premiums than they did a year ago.

More than 342,000 consumers have newly enrolled during the current open-enrollment period, which remains ahead of last year’s pace, and continues in California through Jan. 31.

SACRAMENTO, Calif. — Covered California announced new enrollment figures as it approaches the final weeks of the annual open-enrollment period, and sought to quell consumer confusion by clarifying the federal penalty rules in place for 2018.

Covered California announced that 342,000 new consumers had signed up for health insurance through Covered California through Sunday, Jan. 21. The pace of new enrollees for the current open-enrollment period remains ahead of last year, when sign-ups did not surpass 320,000 until Jan. 23, 2017. In addition to the new sign-ups, more than 1.2 million existing Covered California members have renewed their coverage for 2018. And the good news is that the vast majority will see a decrease in their net monthly premium payment after receiving more financial assistance.

“The demand — as well as the need — for health insurance is as strong today as it was when we first began offering coverage five years ago,” said Peter V. Lee, executive director of Covered California. “The people of California are taking advantage of the quality plans and lower costs available through Covered California in 2018.”

Covered California also reminded consumers that the Affordable Care Act’s individual shared responsibility payment, often called the individual mandate, remains in place throughout calendar year 2018. Consumers who do not have health insurance could face stiff tax penalties if they are not covered. These penalties are a minimum of $695 per adult and $347.50 per child, up to $2,085 per family, or at least 2.5 percent of annual household income - whichever is greater (for an estimated maximum penalty of $3,816 per individual and $19,080 for a family of five). The recent tax bill removes the penalty but it does not go into effect until 2019.

The Internal Revenue Service website currently states “taxpayers remain obligated to follow the law and pay what they may owe at the point of filing‎.”

In addition, the IRS had previously indicated it would not implement a policy proposed by the prior administration to reject tax returns where the consumer did not indicate whether they had coverage during the tax year. This announcement led to confusion in 2017 about the IRS’ intention to enforce the federal penalty. In October 2017 however, the agency announced that in order “to avoid refund and processing delays when filing their 2017 returns in 2018,” consumers should indicate “whether they and everyone on their return had coverage, qualified for an exemption from the coverage requirement or are making an individual shared responsibility payment.” Click here to see the IRS announcement: https://www.irs.gov/tax-professionals/aca-information-center-for-tax-professionals.

“The real penalty for not having health insurance is getting sick or injured and facing medical bills that are in the tens or even hundreds of thousands of dollars,” Lee said. “Health insurance provides security and peace of mind, and this year we are seeing that coverage is more affordable than many people think.”

Open enrollment, which continues through Jan. 31, is the one time each year — if your life circumstances have not changed — that health insurance companies must take everyone who wishes to sign up.

A recent Covered California analysis found that the net monthly premiums for enrollees who receive financial help are on average 10 percent lower than what new and renewing consumers paid last year. The lower prices are a result of more financial help being available for consumers who qualify for assistance. The Affordable Care Act is designed to protect consumers by providing more premium tax credits when premiums rise. And for the many Californians in the individual market who do not get financial help, the robust competition has meant that for many, premium increases have been kept in the single digits.

Since 2014, more than 3 million people have purchased health insurance through Covered California, and nearly 4 million have enrolled in the state’s Medi-Cal program. Together, the gains have cut the rate of the uninsured in California from 17 percent in 2013 to a historic low of 6.8 percent as of June 2017.

Consumers interested in learning more about their coverage options should go to www.CoveredCA.com where they can get help to enroll. They can explore their options and find out if they qualify for financial help by using the Shop and Compare Tool. They can also get free and confidential enrollment assistance by visiting www.coveredca.com/find-help/ and searching among 800 storefronts statewide, or more than 17,000 certified enrollers who can assist consumers in understanding their choices and enrolling, including individuals who can assist in other languages. In addition, consumers can reach the Covered California service center by calling (800) 300-1506.

About Covered California Covered California is the state’s health insurance marketplace, where Californians can find affordable, high-quality insurance from top insurance companies. Covered California is the only place where individuals who qualify can get financial assistance on a sliding scale to reduce premium costs. Consumers can then compare health insurance plans and choose the plan that works best for their health needs and budget. Depending on their income, some consumers may qualify for the low-cost or no-cost Medi-Cal program.

Covered California is an independent part of the state government whose job is to make the health insurance marketplace work for California’s consumers. It is overseen by a five-member board appointed by the governor and the Legislature. For more information about Covered California, please visit www.CoveredCA.com.

An analysis of potential premium changes in states across the nation shows increases of 16 to 30 percent likely in 2019 if federal steps are not taken.

While the Patient Protection and Affordable Care Act’s subsidies would largely insulate subsidized consumers from these costs, millions of unsubsidized consumers would pay the full price of these increases. Many would likely be priced out of coverage.

Continued policy and premium uncertainty risks further carrier withdrawals, leaving more consumers with only one health plan and even the prospect of “bare counties.”

The analysis reviews three federal policy options that could stabilize markets and mitigate the impact of premium increases in many states.

Covered California’s open-enrollment period is still underway and consumers have through Jan. 31 to sign up for coverage.

SACRAMENTO, Calif. — Covered California issued an analysis Thursday that examined the potential impacts of the current open-enrollment period — which remains open in California, but ended in federally facilitated marketplace states on Dec. 15 — and of recent federal decisions on premiums in individual markets across the nation. The analysis found that premiums could increase dramatically in 2019, with increases from 16 to 30 percent if no steps are taken to mitigate these increases.

“Recent federal decisions are threatening to dramatically increase premiums for millions of people,” said Peter V. Lee, executive director of Covered California. “This report underscores the fact that health care is local, but also that no state is immune from the impacts of recent federal policies.

“There are immediate steps that can be taken at the federal level to reduce those risks and protect millions of Americans. Absent federal action, the health insurance premiums paid by the over 6 million Americans who do not receive federal subsidies will increase dramatically in 2019, with some states facing 30 percent spikes in premiums.”

The individual marketplace faced several challenges in the past year, and the 2019 plan year has the potential to be just as volatile and uncertain. Three recent federal actions identified by the report that could potentially influence premiums in 2019 are:

Removing the Penalty: The Tax Cuts and Jobs Act eliminated the penalty for not having health insurance starting in 2019. Independent analysis projects drops in enrollment, and because those dropping coverage are likely to be healthier, premium increases for those who remain that could range from 8 to 13 percent.

Reduced Marketing and Outreach: The federal government reduced its marketing investment by 90 percent, from $100 million to $10 million, and its outreach budget from $63 million to $37 million. The reduced investments come on the heels of the administration’s decision to pull its marketing during the last week of open enrollment in January 2017. During that time, the enrollment in the federally facilitated marketplace has dropped nearly 10 percent (see Table 1).

While California and other state-based marketplaces are not affected by these decisions, the 39 states served by the federally facilitated marketplace (FFM) could face premiums that are 4 to 9 percent higher in 2019 because of the decision not to promote enrollment.

Short-Term, Limited-Duration Health Plans and Association Health Plans: The potential expansion of short-term, limited-duration plans, and potentially the impact of association health plans selling across state lines, could siphon healthy consumers from the common risk pool of the individual markets, worsening the risk mix and raising premiums for those who remain covered.

“The 9 million Americans who receive subsidies will be protected from these premium increases, which could be more than 30 percent in some regions, because the federal government will pick up most of the costs,” Lee said. “However, 6 million Americans who do not get any financial help — from an employer or the federal government — will not have any protections and will be faced with paying the entire increase by themselves.”

Covered California’s analysis included a detailed summary of the unsubsidized consumers, who are primarily enrolled off-exchange, who would be most directly affected by the potential rate increases. An estimated 6 million people do not receive any financial assistance to help pay for their health insurance. With an estimated median income of $75,000, many are not high-income earners and would most likely struggle to afford premium increases of this magnitude (see Figure 1).

Figure 1: Premium Increases Directly Affect Unsubsidized Consumers

“Without any action, we are talking about millions of working middle-class families who do not get financial help, and who will get hit hard by the choice of paying the full price or giving up the health insurance they need,” Lee warned.

In addition to the higher premiums, the continued uncertainty could force some health insurance carriers to withdraw from their markets, leaving consumers in more regions with no choice of plans in the individual market.

The report analyzed the potential impact of three federal actions that could stabilize premiums for consumers:

Funding State-Based Reinsurance: A state-based invisible high-risk pool or reinsurance — run by states or allowing states to “opt-out” of administering the program and rely instead on CMS to run the program — could produce a rate reduction ranging from 9 to 16 percent and encourage health plans to continue their participation. Earlier this month, Covered California issued a report and analysis of the elements needed to make such programs effective: “Reducing Premiums and Maximizing the Stabilization of Individual Markets for 2019 and Beyond: State Invisible High-Risk Pools/Reinsurance.”

Marketing Investment to Promote Enrollment in FFM States: The federal government’s promoting enrollment by supporting marketing and outreach investments in 2019 could lead health insurance carriers to reduce rates between 2 and 4 percent. The report details the 9 percent decrease in enrollment in FFM states since 2016, with lower enrollment resulting in higher premiums for those who do not receive subsidies. The combined effect of low marketing in 2018 and that policy continuing for 2019 is estimated to result in premium increases that range from 4 to 9 percent. Covered California also released today a study that found the enrollment drop in 2018 could have been even greater if not for a dramatic increase in the news coverage of the enrollment periods and deadlines. Ogilvy, a global leader in communications and media, was commissioned to examine coverage trends for the 2017 and 2018 open-enrollment periods. The report found that mentions of “enrollment,” “enrollment period” and “deadline” increased by 53 percent, 125 percent and 129 percent respectively year over year (see Table 2).

Table 2: Coverage Nationally of Open Enrollment Increased Dramatically Year Over Year: 2017 to 2018

“Studies clearly document that both news coverage and advertising drive enrollment,” said Lee. “Enrollment nationally benefited from a dramatic uptick in coverage for 2018, but there is no reason to expect the same coverage for 2019.”

Reinstituting the Health Insurance Tax Holiday: Providing health insurance carriers with a “holiday” from the health insurance tax could reduce premiums by an additional 1 to 3 percent. A one-year holiday from the health insurance tax is included in a short-term spending bill, currently under consideration in Congress, which aims to avert a federal government shutdown.

“Federal policy clearly makes a huge difference in the lives of millions of consumers — for 6 million, policy choices can mean premiums jumping 30 percent or more. Action is needed in the next months to provide stability and protect consumers from staggering premium increases,” Lee said.

Covered California has long maintained that a robust marketing campaign is key to attracting new consumers to the health exchanges and maintaining a healthy consumer pool that reduces premiums for everyone.

“California has invested heavily in marketing and outreach. These investments, along with other policy choices made in California, have resulted in this state’s having one of the healthiest consumer pools in the nation — this translates directly to lower premiums for those who bear the full cost of their insurance,” said John Bertko, chief actuary of Covered California.

“This analysis uses the best available evidence to assess the potential impacts of a range of policies on premiums across the nation. The report underscores that ‘health care is local’ — the impacts on premiums will vary dramatically by state and by health plan, but it’s clear that many Americans face the prospect of premium increases of 30 percent or more without federal action.”

Covered California also wants consumers to know that while the enrollment deadline for most states was Dec. 15, Californians have through Jan. 31, 2018, to explore their options and select a plan that best fits their needs. Consumers who enroll by midnight on Jan. 19 will have their coverage start on Feb. 1.

A recent Covered California analysis found that the net monthly premiums for the over 1 million Californians who receive financial help are on average 10 percent lower than what new and renewing consumers paid last year. The lower prices are a result of more financial help being available for consumers who qualify for assistance.

Since 2014, more than 3 million people have purchased health insurance through Covered California, and nearly 4 million have enrolled in the state’s Medi-Cal program. Together, the gains have cut the rate of the uninsured in California from 17 percent in 2013 to a historic low of 6.8 percent as of June 2017.

Consumers interested in learning more about their coverage options should go to www.CoveredCA.com where they can get help to enroll. They can explore their options and find out if they qualify for financial help by using the Shop and Compare Tool. They can also get free and confidential enrollment assistance by visiting www.coveredca.com/find-help/ and searching among 800 storefronts statewide, or more than 17,000 certified enrollers who can assist consumers in understanding their choices and enrolling, including individuals who can assist in other languages. In addition, consumers can reach the Covered California service center by calling (800) 300-1506.

About Covered California
Covered California is the state’s health insurance marketplace, where Californians can find affordable, high-quality insurance from top insurance companies. Covered California is the only place where individuals who qualify can get financial assistance on a sliding scale to reduce premium costs. Consumers can then compare health insurance plans and choose the plan that works best for their health needs and budget. Depending on their income, some consumers may qualify for the low-cost or no-cost Medi-Cal program.

Covered California is an independent part of the state government whose job is to make the health insurance marketplace work for California’s consumers. It is overseen by a five-member board appointed by the governor and the Legislature. For more information about Covered California, please visit www.CoveredCA.com.

Consumers have until the end of Friday, Dec. 22, to sign up for health coverage that begins on Jan. 1, 2018. Covered California’s open-enrollment period runs through Jan. 31, 2018.

More than 220,000 new enrollees selected a plan through Dec. 15, which remains ahead of last year’s pace.

Based on the first month’s enrollment, most consumers are paying less for their coverage in 2018.

The impending removal of the individual mandate penalty, with other key actions, means significant uncertainty for 2019 — which could lead to collapsing individual markets in many states in the absence of strong federal stabilization policies.

SACRAMENTO, Calif. — Covered California updated its enrollment data on Wednesday and alerted consumers to a key deadline that is approaching. While the open-enrollment period has ended in most states, uninsured consumers in California have until midnight on Dec. 22 to sign up if they want their coverage to begin on Jan. 1, 2018.

“The time is now to ring in the New Year with a quality health plan that provides protection and peace of mind,” said Peter V. Lee, executive director of Covered California. “We have seen thousands of people signing up every day as we near this key deadline, and Covered California wants to make sure everyone knows that time is running out to get health coverage that starts on Jan. 1.”

The latest data shows that more than 220,000 new consumers signed up for coverage through Dec. 15, which is about 10 percent more than last year, when 199,000 consumers selected a plan during the same time period. In addition, approximately 1.2 million existing Covered California consumers have had their coverage renewed for 2018.

With the continued health care policy debate at the federal level, Covered California also noted that the individual market faces significant uncertainty in 2019. Three of the main causes of this uncertainty are:

Repeal of the individual mandate penalty: Repeal will take effect in 2019, and could threaten the individual market in many states. Health insurance companies rely on certainty when setting their rates, and may decide to exit their markets in the face of an uncertain market caused by a shrinking pool of consumers who are less healthy.

Lack of federal marketing: Health insurance needs to be sold, particularly to young and healthy individuals who are less likely to feel compelled to purchase coverage on their own. The federal administration significantly reduced the marketing and outreach budget for the current open-enrollment period, which could lead to fewer consumers enrolled, a less healthy risk mix and higher premiums for consumers.

Recent executive order: The president’s executive order called for regulations that would allow the sale of “association health plans” or “short-term plans.” Depending on how these regulations are structured, these plans could skim healthier individuals off the individual market and leave consumers without comprehensive coverage. Not only would these consumers be enrolled in “Swiss cheese” policies that were common prior to the Affordable Care Act, those left in the exchanges would see higher premiums because of a less healthy consumer pool.

Without federal action to offset the destabilizing effects of these issues, Covered California estimates that between 10 and 20 states could be left without any carriers in their exchanges in 2019. Consumers in the remaining exchanges could also face dramatically higher premiums, particularly those who do not receive any financial assistance.

During its December board meeting, Covered California discussed several federal policies that could make a difference in stabilizing individual markets across the country and noted that now is the time for bipartisan efforts to protect consumers and lower premiums. These policies include:

Federal marketing commitment: Other bipartisan legislation proposed by senators Lamar Alexander and Patty Murray includes provisions that would require the federal government to spend $100 million annually to promote enrollment. While Covered California relies on its own funding to invest more than $100 million in marketing and outreach, federal proposals like this would inject stability into states that rely on the federally facilitated marketplace.

Restore cost-sharing reduction (CSR) funding: While many states developed a workaround to compensate for the cancellation of reimbursement payments to carriers that provide low-cost services to low-income consumers, it is an imperfect solution that is less effective and actually costs the federal government more through increased tax credit spending. The Alexander-Murray proposal would restore this funding.

Removing the health insurance tax: The removal of this tax, which is included in the Patient Protection and Affordable Care Act, would lead directly to lower premiums.

“President Trump today tweeted that removing the individual mandate penalty ‘means Obamacare is being repealed.’ With that announcement, we hope that Congress and the president can now turn their attention to bipartisan solutions needed to stabilize the individual insurance market across the nation,” Lee said. “While one provision of the Affordable Care Act will go away in 2019 — the tax penalty for not buying insurance — consumers can be confident that they will have access to the same quality, affordable health coverage from Covered California in 2018 and in the years to come.”

Lee added, “The lynchpin of the Affordable Care Act is financial help for millions of Americans and changing the rules so insurers must cover everybody. Those elements remain in place.”

Covered California also wants consumers to know that while the enrollment deadline for most states was Dec. 15, Californians will have through Jan. 31, 2018, to explore their options and select a plan that best fits their needs. While consumers can sign up for coverage in the month of January, if they wait until then, their coverage will not start until Feb. 1 or March 1.

A recent Covered California analysis found that the net monthly premiums for enrollees who receive financial help are on average 10 percent lower than what new and renewing consumers paid last year. The lower prices are a result of more financial help being available for consumers who qualify for assistance. The Affordable Care Act is designed to protect consumers by providing more premium tax credits when premiums rise.

“With the deadline of Friday, Dec. 22, to get coverage that starts Jan. 1, we want to make sure that consumers know about the increased financial help that is available to help bring health care coverage within reach,” Lee said.

Since 2014, more than 3 million people have purchased health insurance through Covered California, and nearly 4 million have enrolled in the state’s Medi-Cal program. Together, the gains have cut the rate of the uninsured in California from 17 percent in 2013 to a historic low of 6.8 percent as of June 2017.

Consumers interested in learning more about their coverage options should go to www.CoveredCA.com where they can get help to enroll. They can explore their options and find out if they qualify for financial help by using the Shop and Compare Tool. They can also get free and confidential enrollment assistance by visiting www.coveredca.com/find-help/ and searching among 800 storefronts statewide, or more than 17,000 certified enrollers who can assist consumers in understanding their choices and enrolling, including individuals who can assist in other languages. In addition, consumers can reach the Covered California service center by calling (800) 300-1506.

About Covered California
Covered California is the state’s health insurance marketplace, where Californians can find affordable, high-quality insurance from top insurance companies. Covered California is the only place where individuals who qualify can get financial assistance on a sliding scale to reduce premium costs. Consumers can then compare health insurance plans and choose the plan that works best for their health needs and budget. Depending on their income, some consumers may qualify for the low-cost or no-cost Medi-Cal program.

Covered California is an independent part of the state government whose job is to make the health insurance marketplace work for California’s consumers. It is overseen by a five-member board appointed by the governor and the Legislature. For more information about Covered California, please visit www.CoveredCA.com.

The number of new consumers signing up for coverage remains ahead of last year’s pace, with more than 38,000 selecting a plan during the past three days.

Consumers now have until the end of Dec. 22 to sign up for health care coverage that will begin on Jan. 1.

Based on the first month’s enrollment, most consumers are paying less for coverage.

Covered California is working to distinguish the deadline for open enrollment in California — which ends Jan. 31 — from the shorter period for much of the nation.

SACRAMENTO, Calif. — In response to a strong surge in demand, Covered California is giving consumers more time to sign up for health coverage that will begin on Jan. 1, 2018.

Over the past three days, Covered California has seen more than 38,000 new consumers sign up for coverage, which means that as of Dec. 13 more than 182,000 new consumers have signed up for coverage since open enrollment began. Compared to the same time last year, when 156,000 had signed up, this enrollment marks an increase of 26,000, or 17 percent. Many of these new members are taking advantage of the fact that the cost of coverage is lower than it was last year for most consumers.

“Covered California is seeing a huge influx of consumers, and we know that not everyone is getting through on the phone or is able to get an appointment with a certified enroller,” said Peter V. Lee, executive director of Covered California. “We’re extending the deadline for Californians to get coverage starting Jan. 1 because we do not want to leave anyone behind. Our responsibility is to make sure we help every single person seeking to enroll get the coverage they need.”

A recent Covered California analysis found that the net monthly premiums for enrollees who receive financial help are on average 10 percent lower than what new and renewing consumers paid last year. The lower prices are a result of more financial help being available for consumers who qualify for assistance. The Patient Protection and Affordable Care Act is designed to protect consumers by providing more premium tax credits when premiums rise.

“Covered California wants to make sure that consumers use the increased financial assistance that is available to help bring health care coverage within reach,” Lee said. “Covered California is here for you today, and we will be here for you tomorrow. Now is the time to sign up for health insurance that can protect you and your family.”

Consumers now have until the end of Dec. 22 to sign up for coverage that will begin on Jan. 1. Covered California also wants consumers to know that while the enrollment deadline for most states is Dec. 15, Californians will have through Jan. 31, 2018, to sign up for coverage. While consumers can sign up for coverage after Dec. 22, their coverage will not start until Feb. 1 at the earliest.

After Jan. 31, Covered California will continue to enroll people who have a change in their circumstances — such as losing their insurance when they leave a job — and enrollment in Medi-Cal is not subject to open enrollment. However, if your life situation has not changed, you will not be able to enroll for coverage in the individual market until next year’s open-enrollment period, whether through Covered California or by enrolling directly with a health plan outside the exchange.

Since 2014, more than 3 million people have purchased health insurance through Covered California, and nearly 4 million have enrolled in the state’s Medi-Cal program. Together, the gains have cut the rate of the uninsured in California from 17 percent in 2013 to a historic low of 6.8 percent as of June 2017.

Consumers interested in learning more about their coverage options should go to www.CoveredCA.com where they can get help to enroll. They can explore their options and find out if they qualify for financial help by using the Shop and Compare Tool. They can also get free and confidential enrollment assistance by visiting www.coveredca.com/find-help/ and searching among 800 storefronts statewide, or more than 17,000 certified enrollers who can assist consumers in understanding their choices and enrolling, including individuals who can assist in other languages. In addition, consumers can reach the Covered California service center by calling (800) 300-1506.

About Covered California
Covered California is the state’s health insurance marketplace, where Californians can find affordable, high-quality insurance from top insurance companies. Covered California is the only place where individuals who qualify can get financial assistance on a sliding scale to reduce premium costs. Consumers can then compare health insurance plans and choose the plan that works best for their health needs and budget. Depending on their income, some consumers may qualify for the low-cost or no-cost Medi-Cal program.

Covered California is an independent part of the state government whose job is to make the health insurance marketplace work for California’s consumers. It is overseen by a five-member board appointed by the governor and the Legislature. For more information about Covered California, please visit www.CoveredCA.com.